Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME85163 | FL |
NPI | 1023021789 |
---|---|
Provider Name | Carol Cox |
First Address | Tampa, FL 33613-4679 |
Second Address | Tampa, FL 33613-4679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 01/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13137 | BLUE CROSS BLUE SHIELD (01) | FL |
264588200 | (05) | FL |
H69669 | (02) | FL |